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Non Life Insurance - If you are an organ donor and already have a health policy, insurers can’t deny renewal

23 Dec 2019

Gurgaon-based Sonali Chatterjee recently took to social media platform Facebook to speak about how health insurers refused to issue a policy to her after she declared that she had donated a kidney in 2002. She was looking for a new policy as she was unable to renew the existing one.

While more people are now pledging to donate their organs after death, live organ donation is still in its nascent stage in the country. According to government-run National Organ and Tissue Transplant Organisation, in 2013, India had 313 deceased organ donors, which increased to 905 in 2017. But numbers on the live donation front look disappointing. According to a news report, for every 200,000 people waiting for a kidney transplant, only 10,000 are able to find a donor. Most kidney transplants are done through live donations.

If you are one of those few people who would like to go for organ donation, here are things you should keep in mind regarding your health insurance.

First, though many health plans cover hospitalization expenses for recipients of organs, only a few cover the donor because organ donation is a voluntary medical procedure. Very few insurers such as DHFL General Insurance and SBI General Insurance include hospitalization expenses for the donor as an add-on benefit but there’s a cap on the cover and other restrictions.

Second, if you want to buy a fresh policy and are an organ donor already, then it’s the insurance company’s prerogative whether it wants to cover you or not. Some companies may decide to not sell you a policy because they may consider you a high-risk case.

Whether or not a policy will be issued to you also depends on the organ that you’ve donated. Insurers Mint spoke to said, in case of a liver transplant, because the organ regenerates itself, there’s a higher chance of an insurance company issuing a policy. However, the chances of getting a policy reduces in case you’ve donated a kidney.

Third, and this works in your favour, an insurer cannot deny renewal of a policy to a donor. In fact, at the time of renewal, you don’t even need to talk about any medical condition to your insurer though you may inform the insurer.

Renewal is a mere payment process which can happen online and, as per the Insurance Regulatory and Development Authority of India (Irdai) rules, insurers can’t deny renewal. However, any delay over the permissible window for renewal may result in the policy getting lapsed. Policyholders, typically, get a buffer of 30 days to renew a policy.

Keep in mind that if you donated an organ before buying a policy and did not declare it to the insurer at the time of buying, the insurer can deny renewal if it finds out you hid the medical information.

However, if you made all the declarations before buying a policy and approached the insurer at the right time for a renewal, you can approach the insurance ombudsman for non-renewal. In case you don’t get a satisfactory solution, you can escalate the issue to Irdai.

Source: Live Mint BACK